Energy
recommendations help countries design school
feeding programmes. These children in Honduras are
getting ready to learn -- by eating lunch.
(FAO/22082/G. Bizzarri)

When countries design school-feeding programmes or
calculate food import requirements, they base their
decisions on standardized estimates of how many calories
people need to lead active and healthy lives. Recently
experts invited by FAO, the World Health Organization and
the United Nations University met at FAO headquarters for
the Expert Consultation on Energy in Human Nutrition. Their
aim was to assess those estimates, revise figures for
certain groups and discuss a new concern in the developing
world: obesity.

"There's been a long lag since the last consultation,"
says Eileen Kennedy, former Deputy Under-Secretary for
Research, Education and Economics for the US Department of
Agriculture and chair of the consultation. "The good news is
that today we have better and more precise information." The
recommendations from the consultation will be released in a
report later this year.

The last time the experts held such a consultation was in
1981. Since then, a number of new tools and new data have
enabled nutritionists to more accurately understand human
energy requirements. At the same time, profound changes in
lifestyle are leading to new health challenges.

Obesity along with hungerOne of the most significant changes is the emergence of
obesity in countries still struggling to end hunger. A
combination of increased income and the availability of more
food, but not necessarily better food, is behind this
change. So too is the fact that activity levels are
decreasing in much of the developing world. In many cases,
obesity occurs in the same household as hunger. (For more
information on obesity, see the FAO in-depth Focus
"The developing
world's new burden.")

The rise in obesity also questions some basic assumptions
about energy recommendations. For example the report from
the last consultation had recommended providing additional
food to undernourished children to allow them to catch up to
normal weight. But at this consultation, experts from a
number of developing countries pointed out a problem with
this approach. "When the information was used to plan
feeding programmes, it actually led to obesity in some
cases," says Prakash Shetty, Chief of FAO's Nutrition
Planning, Assessment and Evaluation Service.

Increased
mechanization means people in the developing world
are becoming less active. A tractor helps plough a
field in Zambia.
(FAO/11165/P. Johnson)

Being active, being fitExperts at the consultation agreed that obesity needs
urgent attention. Part of the solution is promoting physical
activity since activity confers important health benefits
while also burning calories. Everyone profits from increased
activity, not just people who are overweight. "You need to
eat every day and you need to be active every day," says Dr.
Kennedy.

A number of assumptions about lifestyle were also
challenged at the consultation. It turns out that people in
the developing world are becoming less active than they used
to be. Increased automation in agriculture means farmers
expend less energy to get the same work done. And as incomes
rise, people are adopting a more sedentary lifestyle, for
example travelling by motorized vehicle rather than by
foot.

New methods bring new understandingParticipants confirmed the validity of most of the
previous energy recommendations--which was reassuring after
years of criticisms that the figures might be too high. But
better data using new tools led them to revise energy
requirements for certain groups. (For
more information on new tools, click here.) For
instance, scientists discovered that children are less
active than previously thought and as result, need fewer
calories. By contrast, adolescents need more calories.

Revised
recommendations are expected for certain groups.
This woman in Thailand needs enough energy to feed
herself and her baby. (WHO photo)

Specific recommendations for pregnant and breast-feeding
women will also be revised. Energy requirements may decline
in some cases since it turns out pregnant women are less
active than previously thought. But instead of giving a
single recommendation for how much weight gain leads to a
healthy birth, a calculation will be made considering
whether the mother is underweight or overweight.

And whereas the previous recommendations lumped everyone
over 60 years of age in one group, the new guidelines will
have sub-groups. "There's a big difference in energy needs
and expenditures for individuals between 60 and 75 years old
and those who are 75 and over," points out Irwin Rosenberg,
Professor of Physiology, Medicine and Nutrition at Tufts
University School of Medicine. People in their 60s and 70s
may still be very active members of the household. But with
increasing age people tend to exercise less while the body
loses muscle mass -- thus requiring fewer calories overall.
Both factors are more pronounced in those over 75.

The new report will reflect all these changes.

Turning science into policyWhile the physiologists on the expert panel weighed in
on scientific recommendations, the nutritionists must still
turn the findings into practice. "We need to convene another
consultation to make sure this is information developing
countries can use," says Barbara Burlingame Senior Officer
in FAO's Nutrition Impact Assessment and Evaluation Group. A
consultation to address practical applications will be
scheduled sometime after the new guidelines are
completed.

One puzzle still to be solved has to do with the levels
of activity that will be the basis for the new energy
recommendations. The experts agreed on the importance of
using an activity level consistent with good health.
Unfortunately, the amount of physical activity discussed was
higher than most people currently practice -- just at a time
when people are becoming less active. If revised
calculations translate into higher calorie levels without a
concurrent increase in activity, the result could be more
obesity, which is just what the developing world doesn't
need.